Is an unhealthy work environment in nursing home care for people with dementia associated with the prescription of psychotropic drugs and physical restraints?

Willemse, Bernadette M., de Jonge, Jan, Smit, Dieneke, Dasselaar, Wouter, Depla, Marja F. I. A. and Pot, Anne Margriet (2016) Is an unhealthy work environment in nursing home care for people with dementia associated with the prescription of psychotropic drugs and physical restraints?. International Psychogeriatrics, 28 6: 983-994. doi:10.1017/S1041610216000028


Author Willemse, Bernadette M.
de Jonge, Jan
Smit, Dieneke
Dasselaar, Wouter
Depla, Marja F. I. A.
Pot, Anne Margriet
Title Is an unhealthy work environment in nursing home care for people with dementia associated with the prescription of psychotropic drugs and physical restraints?
Journal name International Psychogeriatrics   Check publisher's open access policy
ISSN 1741-203X
1041-6102
Publication date 2016-06-01
Year available 2016
Sub-type Article (original research)
DOI 10.1017/S1041610216000028
Open Access Status Not Open Access
Volume 28
Issue 6
Start page 983
End page 994
Total pages 12
Place of publication Cambridge, United Kingdom
Publisher Cambridge University Press
Collection year 2017
Language eng
Formatted abstract
Background: Research showed that long-term care facilities differ widely in the use of psychotropic drugs and physical restraints. The aim of this study is to investigate whether characteristics of an unhealthy work environment in facilities for people with dementia are associated with more prescription of psychotropic drugs and physical restraints.

Methods: Data were derived from the first wave (2008–2009) of a national monitoring study in the Netherlands. This paper used data on prescription of psychotropic drugs and physical restraints from 111 long-term care facilities, residing 4,796 residents. Survey data of a sample of 996 staff and 1,138 residents were considered. The number of residents with prescribed benzodiazepines and anti-psychotic drugs, and physical restraints were registered. Work environment was assessed using the Leiden Quality of Work Questionnaire (LQWQ).

Results: Logistic regression analyses showed that more supervisor support was associated with less prescription of benzodiazepines. Coworker support was found to be related to less prescription of deep chairs. Job demands and decision authority were not found to be predictors of psychotropic drugs and physical restraints.

Conclusions: Staff's job characteristics were scarcely related to the prescription of psychotropic drugs and physical restraints. This finding indicates that in facilities with an unhealthy work environment for nursing staff, one is not more likely to prescribe drugs or restraints. Further longitudinal research is needed with special attention for multidisciplinary decision making – especially role of physician, staff's knowledge, philosophy of care and institutional policy to gain further insight into factors influencing the use of psychotropic drugs and restraints.
Keyword Work environment
Work control
Job autonomy
Time pressure
Dementia care
Long-term care
Chemical restraints
Antipsychotics
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Psychology Publications
 
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